PURPOSE: To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. MATERIALS AND METHODS: Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in all cases. RESULTS: Among the five patients who encountered problems, breakage of the olive tip occourred in three, upward displacement of the stent in two, and improper expansion of the distal portion of the stent, unrelated with the obstruction site, in one. The broken olive tip was pushed to the duodenum in two cases and to the peripheral intrahepatic duct in one. Where the stent migrated during withdrawal of its introduction system, an additional stent was inserted. In one case, the migrated stent was positioned near the liver capsule and the drainage catheter could not be removed. CONCLUSION: Although the number of patients in this study was limited, some difficulties were encountered in withdrawing the stent's introduction system. To prevent the occurrence of this unusual complication, the stent should be appropriately expansile, and shape in the olive tip shoud be considered.
Catheters ; Cholangiocarcinoma ; Cholangiography ; Drainage ; Duodenum ; Humans ; Liver ; Olea ; Palliative Care ; Seoul ; Stents*

STATEMETN OF PROBLEM: In-Ceram system is one of the all-ceramic crowns that can be used in anterior 3 unit fixed partial dentures and posterior single crowns. The alumina core used in In-Ceram system is manufactured using slip-casting technique. The slip-casting technique is difficult and technique sensitive. To improve this problem, tape-casting method was introduced into dentistry. There were no studies to examine the effect of margin design on the margin fit-ness of all-ceramic crowns fabricated from alumina tape. PURPOSE: The purpose of this study was to compare the marginal fitness of glass infiltrated alu-mina core fabricated from aqueous-based alumina tape according to different margin types (90 .,110 ., 135 .shoulder margin). MATERIAL AND METHOD: Three upper central resin incisors were prepared with 90 ., 110 .and 135 .shoulder margins for all-ceramic crowns, respectively. The resin teeth were duplicated and master die and special plaster die were made as usual. After alumina cores were fabri-cated from aqueous-based alumina tape, cores were cemented to each 15 epoxy dies replicated from three resin teeth with resin cement. These cemented cores were embedded in epoxy resin. Specimens were cut mesiodistally and buccolingually. Marginal gap and discrepancy were measured under microscope. RESULTS: The marginal gap and discrepancy of 90.marginal angle was 75.1 mu m, 86.6 mu m, 110 .marginal angle was 41.5 mu m, 50.7 mu m and 135 .marginal angle was 51.7 mu m, 54.2 mu m, respectively. The smallest value was seen in 110 (angle, which was statistically significant com-pared to that of 90 .angle (p<0.05). CONCLUSION: Marginal fitness of alumina cores made of alumina tape with 110 .shoulder mar-gin was best and others were clinically acceptable.
Aluminum Oxide* ; Crowns ; Dentistry ; Denture, Partial, Fixed ; Glass* ; Incisor ; Resin Cements ; Shoulder ; Tooth

PURPOSE: Of the cancers in childhood, leukemia is the most frequent one. For the desirable control of childhood leukemia, the basic data for the incidence has a great importance. The authors made a report about the incidence of leukemia in childhood, which analyzed the data from 126 cases in Kyongnam province, Korea, during 1991~1995. METHODS: The data were obtained from 126 new cases of childhood leukemia who had been living in the Kyongnam province and were diagnosed at the 26 university hospitals or general hospitals in the Kyongnam area and other cities from 1991 to 1995. RESULTS: The age-and-sex adjusted annual incidence rate per 100,000 population during 1991~1995 varied from 1.82 to 2.86, and cumulative annual incidence rate was 2.41 (male 2.26 and female 2.57 respectively). Male to female sex ratio was 1:1 in total cases. By the major types of childhood leukemia, the cases were composed of acute lymphocytic leukemia 70.6%, acute myelocytic leukemia 26.9% and chronic myelocytic leukemia 2.5%. The cumulative annual incidence rate per 100,000 population (crude rate) during 1991~1995 were 2.77 in Ulsan city, 2.62 in Chinju city and 2.34 in the whole area of Kyongnam province. CONCLUSION: It was concluded that the age-and-sex adjusted annual incidence rate per 100,000 of childhood in Kyongnam province was 2.41, which was lower than that in Pusan city in the same period. And, there was no significant difference of the cumulative annual incidence rate between Ulsan area and Chinju area in the same period.
Busan ; Female ; Gyeongsangnam-do* ; Hospitals, General ; Hospitals, University ; Humans ; Incidence* ; Korea* ; Leukemia* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Leukemia, Myeloid, Acute ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Sex Ratio ; Ulsan

BACKGROUND AND OBJECTIVE: Buckwheat is considered one of the most important food allergens in Korea. Although a very small amount is ingested or inhaled, it can cause serious allergic reactions. However, the major allergens of buckwheat still remain to be elucidated. The aim of our study was to identify and characterize the major allergen of buckwheat seed. MATERIAL AND METHOD: Dialysis membrane with a cut-off MW 1kD was used for the preparation of crude buckwheat seed allergen extract. SDS-PAGE under reducing conditions and IgE immunoblotting were performed using sera from 15 buckwheat sensitive subjects. Isoelectric focusing and lectin blotting assay were done. RESULT: Western blot analysis showed more than 15 IgE-reactive buckwheat proteins. Among them, a 24kD protein was shown to be the most frequently bound to sera from allergic subjects (54%). Isoelectric point of 24kD protein was around 5.9. In lectin blotting assay, 24kD protein did not bind to Con A nor five other lectins. CONCLUSION: A 24kD protein was the most frequently recognized allergenic component in buckwheat seed. Isoelectric point was around 5.9. Glycosylation was not detected in 24kD of buckwheat protein.
Allergens ; Blotting, Western ; Dialysis ; Electrophoresis, Polyacrylamide Gel ; Fagopyrum* ; Glycosylation ; Hypersensitivity ; Immunoblotting ; Immunoglobulin E ; Isoelectric Focusing ; Isoelectric Point ; Korea ; Lectins ; Membranes

PURPOSE: A Cow's milk allergy (CMA) is one of common problems during first year of life. Though milk caused allergic problems, their parents didn't know it, and gave milk to their children. But the parents don't give milk to their children if they know it. Therefore it may cause problems of growth and development in children. The purpose of this study is to analyze those clinical features of milk allergy confirmed by oral provocation test. METHODS: We carried out the retrospective study on 21 patients who had been performed oral milk provocation test at Yonsei university children's allergic clinic. RESULTS: 9 out of 21cases (43%) showed positive milk oral provocation test. The most common clinical symptom & sign was urticaria, followed by respiratory symptoms and abdominal symptoms. The rate which past history and positive skin test corresponded to oral provocation test was very high (100%). CONCLUSION: The most valuable diagnosis of food allergy is oral provocation test. However, predictive value of allergy skin test and past history was very high in milk allergy.
Child ; Diagnosis ; Food Hypersensitivity ; Growth and Development ; Humans ; Hypersensitivity ; Milk Hypersensitivity ; Milk* ; Parents ; Retrospective Studies ; Skin Tests ; Urticaria

PURPOSE: Cat is the pet which many of us quite frequently contact without any specific precautions. According to the allergy skin tests conducted in children, cat antigen shows a comparatively high positive reaction, and past history also shows that there are many patients who suffer allergies from cat contacts. Therefore, once it is diagnosed as an allergy caused by cat, it is important that patients be isolated in order to restrict their contact with cat. In this context, this study was conducted for the purpose of finding out how serious and how frequent the allergies by cat contacts are. METHODS: Forty five children patients who visited to the Allergy Clinic for Children, Severance Hospital annexed to the Medical College, Yonsei University were enrolled in this study. Some of patients had shown a positive reaction against cat antigen in the allergy skin test, and others had a past history of developing symtoms when contacted by cat. The patients were isolated from cat for seven days, and then contacted with cats for 30 minutes and observed the provocated symptoms. RESULTS: 1) Among the tested patients, the number of cases who were provocated by the symptoms after cat contact were 18 (40%). 2) Among those patients who were shown to be positive only in allergy skin test, only 24.2% proved to be provocated by the symptoms, while 90.0% of those who had a past history in addition to allergy skin test proved to be provocated by the symptoms. 3) Symptoms provocated after cat contact showed allergic rhinitis patients 88.2% which was the highest ratio, bronchical asthma, 35.3%, urticaria, 29.4%, and allergic conjunctivitis, 23.5%, respectively. 4) The onset and duration of symptoms provcated were under 10 minutes and from 30 to 60 minutes, which included most cases in the test. 5) Total IgE and eosinophil count of patients did not show any meaningful differences between the group which was provocated and that which was not provocated. CONCLUSION: It was shown that 40% patients who were suspected of cat allergy had a positive reaction to the cat contact provocation test. Ninety percents of patients who showed both positive allergy skin test and past history were provocated after cat contact.
Animals ; Asthma ; Cats* ; Child ; Conjunctivitis, Allergic ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Rhinitis ; Skin Tests ; Urticaria

PURPOSE: There are compelling evidences that house dust mites are important in the pathogenesis of atopic dermatitis. Recently, detection of house dust mite allergens from clothing, skin, and dust from human hair has been reported. To evaluate the importance of house dust mite exposure in the clinical severity of atopic dermatitis. METHODS: We measured house dust mite allergens (Der f1 from Dermatophagoides farinae and Der p1 from D. pteronyssinus) in scalp dander from 27 children with atopic dermatitis and 41 children with asthma only by enzyme-linked immunosorbent assay and examined correlation between house dust mite allergen concentrations in scalp dander and clinical severity of atopic dermatitis in children. RESULTS: Der f1 was detectable in scalp dander samples of 32 patients (47%) from overall 68 patient and Der p1 was detectable in 33 patients (49%). House dust mite allergens (Der f1 or Der p1) were detectable in scalp dander samples of 46 patients (70%) from overall 68 patient. There was no significant differences in house dust mite allergen levels between atopic dermatitis patients and patients with asthma only. There was a tendency of inverse correlation between frequency of scalp washing and concentration of Der f1 in scalp dander extract (r=-0.24, P=0.052). There was a significant correlation between severity grade of atopic dermatitis and concentration of Der f1 in scalp dander (r=0.39, P<0.05) in 27 children with atopic dermatitis. However, there was no significant correlation between severity grade of atopic dermatitis and concentration of Der p1 in scalp dander (r=-0.05, P>0.05). CONCLUSION: There was a significant correlation between house dust mite allergen concentrations in scalp dander and clinical severity in children with atopic dermatitis. And these results suggest that exposure to house dust mite allergen is important in the pathogenesis of atopic dermatitis.
Allergens ; Asthma ; Child* ; Clothing ; Dander* ; Dermatitis, Atopic* ; Dermatophagoides farinae ; Dust* ; Enzyme-Linked Immunosorbent Assay ; Hair ; Humans ; Pyroglyphidae* ; Scalp* ; Skin

BACKGROUND: Propofol is a rapidly acting intravenous anesthetic agent used for the induction of anesthesia with a low incidence of side effects. But propofol has a high incidence of pain during intravenous injection, and many methods have been used to minimize the incidence and severity of this pain. The aim of this study was to compare the use of thiopental and lidocaine mixed with propofol for the reduction of pain during the injection of propofol. METHODS: Sixty healthy ASA physical status I or II patients scheduled for general anesthesia were randomly divided into three groups. Each patient received mixed propofol solution (normal saline 1 cc, thiopental 0.5 mg/kg, lidocaine 0.5 mg/kg) via 20 G angiocatheter inserted at the antecubital fossa. The assessment of pain was done at the induction of anesthesia and at the recovery room. The severity of pain was classified as none, mild, moderate, and severe. RESULTS: The severity and incidence of pain diminished significantly in the thiopental group and the lidocaine group compared with control group at the induction of anesthesia (p<0.05), and there was no significant difference between the thiopental and the lidocaine group. Recall of pain during intravenous injection at the recovery room has no significant difference among three groups. CONCLUSIONS: Mixd administration of thiopental or lidocaine could significantly reduce the severity and incidence of pain for intravenous injection of propofol.
Anesthesia ; Anesthesia, General ; Humans ; Incidence ; Injections, Intravenous ; Lidocaine ; Propofol* ; Recovery Room ; Thiopental*

PURPOSE: Mold allergy is the one of the major causes of atopic diseases including asthma, and the Alternaria exists year-round in Korea is recognized as an important cause of many atopic asthma. Recent studies stress the significance of Alternaria as a cause of respiratory problems although detailed knowledge on this organism is limited, especially the relationship of the fungi to respiratory ailments as well as the allergenic nature of this organism. METHODS: The authors studied the purification methods of Alternaria allergen and examine how the allergen acts on atopic asthma. The Alternaria samples were cultured in potato-dextrose broth for 10 days, and a crude extract was obtained after dialysis and filtration. The crude extract was subjected to SDS-PAGE followed by staining, and the allergen was analyzed. Three subjects who showed positive allergy skin test to Alternaria were subjected to RAST and allergy skin test with the crude extract. RESULTS: SDS-PAGE of the curde extract showed more than 30 allergenic bands, and among those, 5 kD, 28 kD, 31 kD and 34 kD bands were the major allergens, indicating that the purification method used in the present study produced an extract with almost all major allergens. In 3 patients with Alternaria allergy we carried out allergy skin test with crude extracts. All three subjects showed positive allergy skin test. CONCLUSION: The crude extract obtained major allergens including 70 kD, 65 kD, 34 kD, 31 kD, 28 kD and 16 kD allergens, and like the results reported outside Korea. Alternaria was proved to be a major allergen in atopic asthma in Korea as well.
Allergens* ; Alternaria* ; Asthma ; Complex Mixtures ; Dialysis ; Electrophoresis, Polyacrylamide Gel ; Filtration ; Fungi ; Humans ; Hypersensitivity ; Korea ; Skin Tests

PURPOSE: Adverse reactions to mosquito bites have been recognized for some time, and these usually consist of large swellings, generalized urticaria, angioedema, and less frequently asthma. There have been some efforts to define immunologic characteristics of mosquito allergens throughout the world. But, in Korea, the immunologic analysis of mosquito allergen have not been made. METHODS: Extracts of locally distributed female mosquito Culex pipiens, were prepared from their heads and thoraxes. By sodium dodecylsulfate-polyacrylamide gel electrophoresis, proteins of two extracts were isolated. Then their proein bands were transferred to nitrocellulose membrane. Immunoblotting was performed with sera of allergic patients to mosquito bites, then completed by antibodies to human IgE. RESULTS: Immunoblotting showed IgE binding proteins weighing 70 kD, 60 kD, 34 kD in Culex pipiens. CONCLUSION: We found that mosquito antigens induced IgE response, and it suggested that species-specific antigens exist. Further investigation using salivary gland extracts from Culex genus are needed in identifying specific allergens.
Allergens* ; Angioedema ; Antibodies ; Asthma ; Collodion ; Culex* ; Culicidae* ; Electrophoresis ; Female ; Galectin 3 ; Head ; Humans ; Immunoblotting ; Immunoglobulin E ; Korea ; Membranes ; Salivary Glands ; Sodium ; Thorax ; Urticaria